Aygestin (progestin) anyone?

Hello Everyone,
After wasting a year with a gyn/endo I specifically travelled to Philly to see (had to take off from work because of her strange hours), I am finding out that much of my pain has to do with her experimentation with me....

For one, my endo finally put me on .05 Vivelle dot, after suffering with hot flashes for months. Prior to this she had me on .025 and then I begged her to put me on .0375 (and prometrium) only to have bleeding and end up with a thickened uterine lining. To combat this, she put me on 4 times the normal dose of progesterin (aygestin) and now I am bleeding again on the .05. Needless to say, I think I have to cut back on the aygestin.

When you say "4 times the normal dose", how much are you talking about? And how often?

Me personally, I am not a fan of Aygestin. My doctor prescribed one course of it once about 2 1/2 years ago because I had an anovulatory cycle...it made me crazy. A few months later, he prescribed it again because my cycle was a little late and I wanted to try getting an IUD (which didn't end up happening)....I lasted 5 days and told him that either my head was going to blow up or I was going to jump out of a window....the head pain was excruciating. That was at the 5 mg dose.

When I had to start HRT this past June, I KNEW I didn't want this as the progesterone/progestin component of my therapy. I have had pretty good luck with the Prometrium 200 mg/10 days per month. The first couple of months were a little rough, headachey about midway through, lots of cramping....the last two months, though, I didn't get a headache until day 9 although the cramping can still get my attention -- I never had menstrual cramps, though, so I guess it's my turn, fair is fair. If the Prometrium fails to give me a bleed, I do have a course of the Aygestin at the ready....was told to take just 2.5 mg for 10 days....so far, though, I have not needed it.

I believe that there are some on this board that have had good luck with the Aygestin. Hopefully you will get some feedback from them.

Hi Barbie,
Would you please provide the actual dosages and your age (and any other relevant info)? That will help us give you a better answer. Do you have a new doctor? Was the last doctor a Reproductive Endocrinologist? (different from a regular endocrinologist or a gynecologist ).

I did take Aygestin in the past. I prefer Prometrium, but Aygestin was fine. I found it to be much less emotionally taxing than Provera.
Thanks,
Laura

Hi all,
I was taking Vivelle dot (starting at .0025) with prometrium 100 mg. This past August, I kept bleeding so an u/s revealed a uterine lining of 6 cm (I think above 5 is borderline/not good). So, the doctor switched me to 10 mg. per day of Aygestin (the normal dose is 2.5) and I've been on that since August. No problems until now. I realize the aygestin was supposed to be a short term remedy to get my lining down, which I assume it did since I did not bleed. Now on the new Vivelle for a month (.05) after months of sweating and hot flashing, I am bleeding. My endo has told me to go back to the aygestin at the normal dose of 2.5mg.

I guess the prometrium just wasn't working because of the lining. Is this possible? I was happy enough on the prometrium. I haven't had any side effects from the aygestin, that I know of. So, if it works, then I guess I will stay with it. If not, then on to the next one, right?

I had thyroid cancer is 00 and am on Synthroid. I like my endo. He is easy to reach, intelligent and has offered to take over my HRT situation, since I keep having a hit or miss with gyns. 10 years ago I was told that I would go into early menopause, after having secondary infertility (despite a good FSH, my estrogen was low and I had trouble being stimulated by the fertility drugs... I managed to get pregnant thru IVF..I spent many years in depression over their proclamation that I would go into early meno, but since going on antidepressants and realizing that it is not the end of the world, just want to get my quality of life going. I have two great kids, move on...). So, for the past 10 years, I've had some symptoms and have gone from gyn to gyn only to be told that I was not going to go thru early meno, etc.

My endo belived me. He's very good. The gyn/endo in Philly constantly had me on and off the patch to check my levels. It was a true roller coaster and very upsetting.

I do need a gyn for the annual visit and I am going to see one of Fri. to get a "second opinion" on my regimen (.05 Vivelle with aygestin at 2.5 mg) continuous. I am hoping to up my Vivelle in a month or two, if my hot flashes continue.

Hi,
Thanks for the additional info. I'm going to repeat my advice that you see a RE to go over your bleeding and lining issues. A gyn is fine for basic stuff and uncomplicated HRT situations, but you have low estrogen but not high FSH, and therefore not a straightforward diagnosis, a lining issue in the past, and bleeding issues. Any one of these alone would make me suggest an RE versus a Gyn. I'm sure your endo is great, but he/she doesn't have the advanced fellowship training in reproductive hormone issues the way that the RE does. Could you get a referral from either your endo or gyn to an RE they suggest? Where do you live? Maybe someone could suggest their RE to you.

Part of your issue could be that you are in flux with your estrogen levels and FSH. You said your estrogen was low-do you know how low and on which day of your cycle (low estrogen is normal at the beginning of a non-meno woman's cycle). Did you just have one test to determine this? Were you still getting cycles? You might want more hormone testing off of all hormones for 2 weeks if you can stand it.

Bleeding is frustrating and annoying. I'm sorry you're dealing with it. Unfortunately, it happens to different women for different reasons. For instance, I bleed when my estrogen is too low. For many others it's when their estrogen is too high. Some women bleed on continuous HRT while others finally find relief from bleeding issues only on continuous - aargh. So, there can be some trial and error. Would you consider cyclical HRT with a bleed each month or every 3 months? It might give you some piece of mind regarding your lining building up to know you are shedding it regularly.

Thanks. I know bleeding is a cause for concern. 10 years ago I had a normal FSH and lowish estrogen, which is why my POF was predicted. I now have a high FSH (around 30) and have been adding more and more estrogen.

One of the things I'm not clear on is when/why a doctor would recommend continuous progestin vs cyclical. Some of us here take it every day, some (like me) take it for 10-12 days per month and some only take it quarterly. What determines what your doctor recommends? Does anyone know?

Barbie, my Dr just increased my Vivelle dosage to .1 from .05 because after 4 months on the .05, my E2 only rose to 29 from 16 (I just started HRT in June). I was not having hot flashes at all on the .05. I did, however, seem to be starting my bleed mid-way through the Prometrium course. When I expressed some concern about going from the .05 to the .1, my Dr told me that I am still young enough (someone thinks so!!) to be able to tolerate it just fine, but to let him know if I have trouble. After 1 month, I am sleeping even better (almost like the Prometrium induced sleep!), my skin and hair seem more supple....the only negatives I can see so far are nipple soreness and a mild back ache when I wake up each day (not sure if this is the back ache noted in the side effects or if it is from sleeping so hard that I don't move much at night!).

Good luck, I hope that you can find a combination that works for you very soon!

Saw my new gyn today who has put me on BCP Yaz. I asked repeatedly if this would be enough estrogen and she said we'd see. I think I should be on .075 or .1, as you are. I made an appt to see her in Jan. She doesn't seem to believe in the numbers. She says it's where I feel good.

With every doctor comes a new opinion. For now, I just want to cry. In a few days, I'll regroup and see what I want to do, such as insist on blood work.

Thanks for listening. According to their measurement of me, I've shrunken 1/4 of an inch (different office, different place, though).

I've had some friends and acquaintances who have been put on BCPs just to "get them through" menopause....but these are not women who experienced POF or EM. Before I realized that I didn't NEED birth control anymore, I tried BCPs...my Dr put me on Loestrin 24 FE for a period of time a little over a year ago...that lasted all of 5 months, as did the Mirena after that. With the Loestrin, I started to get dizzy, headaches daily, anxious and finally ended up with my blood sugar spiking, something that has NEVER happened before. I was sitting in a movie theater and all of a sudden, I felt intense heat that started in my feet and traveled up till it go to my head...I was almost immobile after...I thought I was having a stroke. Went to the Dr and was told that my blood sugar was way out of whack. I decided to stop the Loestrin and my headaches went away...blood sugar restested a few weeks later and it was normal. Started the Mirena and the headaches were back. The Loestrin is high in progestin and of course the Mirena only has progestin...which is why I was leery of this component of my HRT. I am cautiously optimistic regarding the Prometrium.

My Dr said that he is as much a "How you look" and "How you feel" type as "What the numbers say"....he did, however, tell me that I looked like hell back in June...justifiably so, given an E2 of just 16...good thing we have a 20+ year relationship! I would insist on blood work....how could your Dr not believe the numbers??

The 1/4" is probably just margin of error....but I do understand how frustrated you must be! Keep track of your symptoms on the Yaz...not everyone tolerates it well. Take care of yourself!